Provider Demographics
NPI:1295781540
Name:MCPARLAN, LINDA (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MCPARLAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23829 LITTLE MACK AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1186
Mailing Address - Country:US
Mailing Address - Phone:586-773-1300
Mailing Address - Fax:586-773-1600
Practice Address - Street 1:23829 LITTLE MACK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1186
Practice Address - Country:US
Practice Address - Phone:586-773-1300
Practice Address - Fax:586-773-1600
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704195160363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOH21741OtherNURSE PRACTITIONER GROUP
MION11180Medicare ID - Type Unspecified